August 2008
Creating a transformative culture

Jared N. Schwartz, MD, PhD

I like this job, I really do, but every pearl has its oyster and there are always things you have to wrestle with to get to where you’re going. I had to deal with one of those a few weeks ago, probably the toughest assignment I’ve had yet. I’m not complaining, but I think you’re entitled to know. After all, it’s your organization; I’m just here for a couple of years to hold the tiller.

The whole business, which took forever, got me to thinking about The Carrot Principle by Adrian Gostick and Chester Elton, a wonderful little book about motivation and recognition and building a transformative culture. The authors share what they have learned from massive data on workplace productivity, mostly gathered by a well-regarded consulting firm, The Jackson Organization. Much of their research—200,000 interviews of managers and their employees over a 10-year period—has involved clients in the health care field.

A transformative culture nourishes itself, perpetually generating commitment, teamwork, and engagement. The Carrot Principle talks about leadership in terms of developing potential and creating a workplace that features frequent, sincere recognition of each person’s contributions. While most managers surveyed will say that compensation and benefits are the greatest motivators, they write, employees consistently rate “feeling appreciated” and “informed” as more important than compensation. And in fact, nearly four in five employees who quit their jobs cite a lack of appreciation as a key reason for leaving.

The CAP is ahead of the game on that one; in fact, last month we celebrated the first annual employee appreciation day. The CAP has always had employee recognition, but it’s a huge event now, very well done. The daylong celebration is called “360” appreciation—not just managers recognizing subordinates but everyone recognizing one another. The idea is to generate an ongoing “attitude of gratitude” year round. I’m told there is research to show that people who increase their levels of gratitude increase their perceived well-being by as much as 25 percent. They also sleep better.

There are 500 people working for the CAP in every capacity from laboratory accreditation to planning for the annual meeting. Increasingly, they work in teams, encouraging, questioning, and holding one another accountable. The official celebration is part of an ongoing program to encourage initiative and teamwork via continuing education and personal development—all part of a transformative culture. And something is working: In the first six months of 2008, an average of 14 CAP staff members participated in each of 43 different learning opportunities. The options are all over the map, from book discussion groups on motivational management to tours of a local hospital laboratory and classes in medical terminology.

The ceremony to present Joe Schramm, manager of business development services for SNOMED Terminology Solutions, with this year’s Georgia Gregory Award was a highlight of employee appreciation day. Named for a much-loved CAP retiree, the award honors someone on the staff who embodies the CAP shared values (quality service, teamwork, respect for diversity, commitment to lifelong learning, and willingness to embrace change). Joe was selected by a staff committee that described him as someone who is never too busy to help others on the team, consistently steps up to take on new responsibilities, never hesitates to “go the extra mile,” and is forever coming up with ideas to improve quality and efficiency.

Which brings me back to the painful task I had to complete a few weeks ago. Every year at the annual meeting, the president is allowed to recognize 10 staff members. Choosing just 10 of the many dozens of remarkable people was pure misery. I did my best, but I was grinding my teeth the entire time. Who’s not on the list? A lot of terrific people who make the CAP what it is, but run beneath the radar for most members. People like instructional designer Eleanore Wojewoda, a medical technologist who came to the Department of Education from the Laboratory Accreditation Program, took night classes to become certified in instructional design, and now creates educational programs for accreditation program inspectors. People like Janice Alexander, an e-learning product specialist who worked her way up from an entry-level post, learning Web software and multimedia tools. Now she’s a course developer and her boss tells me that “if it wasn’t for Janice, there is no way on earth the annual meeting would come off, or the rest of the courses either.”

I ran out of awards before I could get to program manager Keri Gonzalez, a medical technologist who brings invaluable empirical knowledge to her work in competency assessment for laboratory professionals. Or Linda Caradine and Diana Kelker, executive director and assistant director, respectively, of the CAP Foundation, who plan and execute Futurescape, a truly amazing event. Amy Daniels, who manages investigations for the accreditation program didn’t get an award, despite the fact that as point person for laboratories with difficult problems she is thorough and unflappable. Neither did Denise Mack, who supervises the Contact Center and is synonymous with over-the-top service. Or even Joe Schramm.

So you can see why I was so frustrated when it came time to give awards; for everyone named here, there are 10 more just as deserving. It’s my problem, it’s your problem, it’s a nice problem to have.

The physician-staff partnership at the CAP is all about empowerment in an era of transformation, which translates to recognizing potential, nourishing leadership, and encouraging initiative. Robust, creative, and sophisticated support will enable us to take our place at the hub of the clinical team. And it is our good fortune to have a fine group of transformative leaders on the CAP staff.